Development for Whom and At What Cost: Population Myths and Realities

When we talk about “development,” the conversation often begins and ends with GDP growth, industrial output, or trade surpluses. But here’s the real question that rarely gets asked: development for whom, and at what cost? This question forces us to look beyond aggregate numbers and confront the lived realities of billions – particularly women, the poor, and marginalised communities. In contexts like India, where population has long been framed as a “problem,” unpacking the myths around population and development is essential for understanding what genuine progress looks like.

Population and economic development: busting the burden myth 🔗

One of the most persistent myths in development discourse is that a large population is inherently a burden – a drag on resources, growth, and prosperity. This narrative has been used for decades to justify coercive population control measures, especially in the Global South. But the evidence tells a more nuanced story.

A large population, when properly supported through education, healthcare, and employment, can be a nation’s greatest asset. It provides a sizable labour force, a vast consumer market, and a pool of human talent that can drive innovation and economic achievement. Countries like China, South Korea, and India itself have demonstrated how investing in people – through family planning, education, and skills development – can convert a so-called population “burden” into a demographic dividend.

The critical factor is not population size alone, but how a country utilises its people. Development is not merely a quantitative process measured in output per capita. It is a multi-dimensional process focused on improving people’s quality of life across social, economic, educational, political, and health dimensions. Reducing the development debate to population arithmetic misses the point entirely.

Human development: beyond economic growth 🔗

If development is not just about GDP, then how should we measure it? This is precisely the question that economist Dr. Mahbub ul Haq set out to answer in the early 1990s. Working with Nobel laureate Amartya Sen at the United Nations Development Programme (UNDP), Haq pioneered the human development paradigm – a framework that fundamentally reoriented how the world thinks about progress.

Haq argued that the ultimate purpose of development was to improve people’s lives, and that economic growth was only a means to this end, not the end itself. His landmark work, Reflections on Human Development, laid out a vision where income was treated as an essential means but not as the sum total of human life. The human development paradigm instead focused on creating an environment where people could develop their full potential and lead productive, creative lives in accordance with their needs and interests.

The Human Development Index 🔗

This thinking led to the creation of the Human Development Index (HDI) in 1990, which measures national progress not just by income, but by life expectancy, educational attainment, and standard of living combined. The HDI was a deliberate challenge to the dominance of Gross National Product as the sole measure of socio-economic progress. As Haq and his team famously articulated through the Human Development Report, people are the real wealth of nations – not factories, not foreign reserves, not trade balances.

The human development paradigm rests on four key pillars: equity (ensuring fair access to opportunities), sustainability (preserving opportunities for future generations), productivity (investing in people to boost economic output), and empowerment (enabling people to participate in the decisions that shape their lives). This framework reminds us that accumulating wealth can actually obscure the goal of enriching human lives if the benefits are unevenly distributed or come at the expense of health, freedom, or dignity.

The myth of poor families and family planning 🔗

A deeply entrenched myth in population debates is that poor families have many children because they are “irresponsible” or resist family planning. This framing conveniently shifts the blame onto the poorest and most vulnerable, while ignoring the structural factors at play.

The reality is that poor women often have large unmet needs for contraception – meaning they do not want more children but are unable to access or use contraceptives. According to data from India’s National Family Health Survey (NFHS), unmet need for contraception among married women of reproductive age dropped from over 23% in NFHS-3 to about 9.4% in NFHS-5, but the decline has not been uniform across regions and socio-economic groups.

The reasons poor women struggle to use contraception are systemic, not personal. They include lack of awareness about available methods, poor access to healthcare facilities, absence of trained providers, and social norms that discourage contraceptive use. High infant mortality rates among poor families also play a role – when parents are not confident their children will survive, they are less likely to limit family size. It is not resistance to family planning but a rational response to insecurity.

What the data actually shows 🔗

India’s progress in reducing fertility has been significant and has cut across all social groups. The country’s Total Fertility Rate (TFR) declined from 2.2 in NFHS-4 to 2.0 at the national level in NFHS-5, dropping below replacement level. Overall contraceptive use also increased substantially from 54% to 67%. According to NFHS-3, 69% of women aged 15-49 considered two or fewer children as the ideal family size – a statistic that challenges the myth that only educated, urban, middle-class families care about limiting their family size.

Fertility decline has been common across all social groups in India, with variations in extent, degree, and timing. The difference between communities is not about willingness but about access to services, quality of healthcare, and socio-economic conditions. When services are available and accessible, women across the board choose smaller families.

Women’s empowerment and family size 🔗

Demographers Leela Visaria and Vimala Ramachandran, who have extensively researched India’s family planning dynamics, have argued that women – regardless of their economic status – would prefer to limit reproduction if two conditions were met. First, they need confidence that their existing children will survive. Second, they need accessible, respectful reproductive health services that protect their dignity and privacy.

This insight is powerful because it reframes the conversation. The “problem” is not that poor women want too many children. The problem is that the systems meant to support them – healthcare, education, social security – frequently fail them. When women are empowered with information, services, and agency, fertility rates decline naturally, without coercion.

The UNFPA’s State of the World Population Report 2025 reinforces this, noting that India’s real fertility crisis is not about numbers but about choice. The report found that over 36% of Indian respondents reported experiencing an unintended pregnancy, and about 27% of women said they were unable to use a contraceptive of their choice. These gaps between desire and reality point to a failure of systems, not of individuals.

Gender dimensions in reproduction and contraception 🔗

Reproduction is both a biological and a social process. Yet in most societies, the responsibility for managing fertility falls overwhelmingly on women. This is not just unfair – it is a reflection of deep-seated gender power dynamics that shape everything from household decisions to national population policy.

Family planning should be a consultative process for both partners. Women’s reproductive rights – as articulated at the International Conference on Population and Development (ICPD) in 1994 – include the right to self-determination, health, equality, and autonomous decision-making, free from discrimination, coercion, and violence. These are not abstract ideals; they are practical prerequisites for any ethical approach to population policy.

Yet the ground reality in India tells a different story. According to NFHS-5, female sterilisation accounts for 37.9% of all contraceptive use, while male sterilisation (vasectomy) stands at just 0.3%. Female sterilisation alone contributes to 68% of total contraceptive use in the country. About 40% of men in India believe contraception is solely a woman’s responsibility. This imbalance is not accidental – it is the product of decades of policy choices.

Historical shift in contraception responsibility 🔗

Scholar Vanita Nayak Mukherjee has traced how India’s family planning programme underwent a dramatic gender shift over the decades. In the 1950s and 1960s, when India launched the world’s first national family planning programme, the focus was largely on male-centred methods – vasectomy and condoms. Men were the primary participants, and the programme operated with relatively less invasive methods.

The Emergency and its aftermath 🔗

Everything changed during the Emergency period of 1975-77 under Prime Minister Indira Gandhi. A coercive mass vasectomy campaign led to severe public backlash, which contributed to the government’s fall. The political fallout from forced sterilisations made successive governments deeply reluctant to focus family planning efforts on men. The consequence was a wholesale shift of the contraceptive burden onto women.

By the mid-1970s, as Mukherjee documents, contraceptive options for women had expanded to include IUDs like the Copper-T and oral pills – but these were more invasive and had significant side effects compared to condoms and vasectomy. Post-Emergency, women became the primary targets for population control. The methods available in the programme progressively moved from user-controlled options like oral pills to provider-controlled ones like IUDs, and ultimately to terminal methods like tubectomy (female sterilisation). Trials on long-acting hormonal contraceptives – including injectables like Depo-Provera and implants like Norplant – were even conducted on women with questionable adherence to ethical norms of informed consent.

The continuing gender gap 🔗

The numbers paint a stark picture. Between 2008 and 2019, only 3% of all 51.6 million sterilisations performed in India were vasectomies. Despite vasectomy being simpler, safer, and less expensive than tubectomy, deeply entrenched patriarchal norms – including myths that vasectomy causes impotence or weakness – continue to deter men. Meanwhile, about 80% of family planning funds are directed toward terminal methods, primarily female sterilisation.

India’s National Health Policy 2017 set an ambitious target of increasing the proportion of male sterilisation from less than 5% to at least 30%. But as researchers have pointed out, no concrete strategies or roadmaps have been laid out to achieve this. The gap between policy aspiration and ground reality remains wide, and women – especially poor and marginalised women – continue to bear the consequences.

Rethinking development: people first 🔗

The question “development for whom and at what cost?” ultimately forces us to centre people – not statistics – in the development story. When a nation pursues economic growth while ignoring unmet contraceptive needs, when it frames population as a burden rather than an asset, when it places the entire weight of family planning on women’s bodies while men remain absent from the conversation – that is development with a very high human cost.

True development, as Mahbub ul Haq envisioned, is about expanding human choices and capabilities. It means ensuring that every person – regardless of gender, caste, class, or geography – has the freedom and support to lead a life they value. Population policy must be grounded in rights, equity, and dignity, not in targets, incentives, or coercion.

The myths are clear: that large populations are always burdens, that poor people refuse to plan families, that population control requires top-down intervention. The realities are equally clear: people respond to opportunity, women choose smaller families when empowered, and sustainable development requires putting human well-being at the centre of every policy decision.

What do you think? Should development be measured by how much wealth a nation produces, or by how well it enables every citizen to lead a healthy, dignified, and free life? And as family planning increasingly becomes a shared global concern, how can societies ensure that the responsibility – and the choice – is truly shared between men and women?

References

1. https://pmc.ncbi.nlm.nih.gov/articles/PMC6469373/
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3. https://global.oup.com/academic/product/reflections-on-human-development-9780195101935
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6. https://www.pib.gov.in/Pressreleaseshare.aspx?PRID=1843842
7. https://www.routledge.com/Indias-Family-Planning-Programme-Policies-practices-and-challenges/Visaria-Ved/p/book/9781138488441
8. https://india.unfpa.org/en/news/indias-real-fertility-crisis-about-choice-not-numbers
9. https://www.india-seminar.com/2002/511/511%20vanita%20nayak%20mukherjee.htm
10. https://india.unfpa.org/en/news/reducing-her-burden-contraception-critical-step-toward-womens-empowerment
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13. https://www.orfonline.org/research/burden-of-sterilisation-on-women-at-the-cost-of-their-health